Sat October 6, 2012

States Struggle To Manage Meningitis Scare

Nearly two-dozen states are watching for new cases of a rare kind of meningitis, caused by fungal contamination in injections for back pain. Officials say the shots were custom made by a Massachusetts pharmacy that shipped about 17,000 doses to states from New York to California. While the disease cannot spread from person-to-person, at least five people have died and dozens more are sick. The outbreak first showed up in Tennessee as we hear from Daniel Potter of member station WPLN.

DANIEL POTTER, BYLINE: A clinic at St. Thomas Hospital in Nashville received about two thousand of the contaminated shots, and unknowingly gave them to hundreds of patients. Now, dozens of people have been coming in every day worried they have meningitis.

DR. ROBERT LATHAM: That's the thing that keeps me awake at night.

POTTER: Chief of medicine Robert Latham says it can take weeks for affected people to get sick, which is partly why it took so long to find the problem. And treatment is slow-going.

LATHAM: Right now, we're having people who have very, very slowly improving headaches, other altered symptoms, leg pain, bladder weakness. This is very slowly improving. Many of them are so early into it they really can't tell that they're any much better yet.

POTTER: The New England Compounding Center, which prepared the shots, should've had better safeguards, says William Schaffner. He's the chairman of preventative medicine at Vanderbilt, and says sloppy work invites contamination.

WILLIAM SCHAFFNER: It must have been egregious, if the Food and Drug Administration can look at an unopened vial of material and with their naked eye see elements of the fungus in the pharmaceutical product in the steroid. I mean, that's not subtle. That's horrendous.

POTTER: The FDA notes oversight of the compounding pharmacy fell to the state - in this case Massachusetts - in what Schaffner calls a regulatory gap. He says closing that gap should be a priority, though right now treatment comes first. Relatively few of the people who have gotten the tainted shots actually develop meningitis.

SCHAFFNER: It appears at the moment to be really quite low - down around 1 percent or perhaps even less. Boy, is that fortunate. But it remains to be determined.

(SOUNDBITE OF GLASS CLINKING)

TONYA SNYDER: So, right now I'm just going to work underneath a biohazard hood here.

POTTER: That's Tonya Snyder, a medical technologist in the Vanderbilt microbiology lab. The hood works kind of like a fan over a stove, sucking spores out of the air. Snyder has grown some of the fungus from one patient's spinal fluid, and shows me the sample.

SNYDER: So, I've got it underneath the microscope here. And what you'll see are things that kind of look almost like flowers.

POTTER: Snyder will be busy for a while. She'll be working to culture samples from potential meningitis cases for six weeks. For NPR News, I'm Daniel Potter in Nashville.